Trapped in a maze extracting as much money as possible while providing as little value as possible is platform controlled extraction. Our guest this week defines the problem and provides solutions.
Pointing to electric utilities as a viable model was a bit of a record scratch moment in the podcast. I don’t know where you all live but here in NY we are being reamed by utilities and captured public service commissions. The only residents avoiding the pain are those in publicly owned utility areas. And given the example of Wikipedia as a bright unshitty light, then maybe the discussion needs to also include alternative ownership models. Capital is as capital does, no?
One quibble. The guest refers to anesthesiology as an example of an extractive industry. Is the price of providing a safe, high quality anesthetic ”many, many, many times in excess or in multiple of the value provided”?
No.
Do anesthesiologists have monopoly pricing?
No.
In fact, the insurers tell us how much they will pay for our services—take it or leave it. Or Medicare, which pays anesthesiologists less than it costs to provide care.
Ask me how I know.
I will give him the benefit of the doubt that his comment about anesthesiology was off the cuff and not well thought out.
Thanks, Matt. The Private Equity raccoons who ‘roll up’ anesthesia practices may do that as part of their business strategy, but I’m fairly certain there’s not an anesthesiologist among them. Perhaps I’m being too sensitive here, but I think a better way to phrase it would have been “large national private equity-owned anesthesia staffing companies” Then again, ‘anesthesiologists’ is just shorter I guess (though less accurate). Love your work and podcasts.
Definitely one of my favorite episodes. Thanks Matt, Dave, and Tim. Happy Thanksgiving.
Pointing to electric utilities as a viable model was a bit of a record scratch moment in the podcast. I don’t know where you all live but here in NY we are being reamed by utilities and captured public service commissions. The only residents avoiding the pain are those in publicly owned utility areas. And given the example of Wikipedia as a bright unshitty light, then maybe the discussion needs to also include alternative ownership models. Capital is as capital does, no?
One quibble. The guest refers to anesthesiology as an example of an extractive industry. Is the price of providing a safe, high quality anesthetic ”many, many, many times in excess or in multiple of the value provided”?
No.
Do anesthesiologists have monopoly pricing?
No.
In fact, the insurers tell us how much they will pay for our services—take it or leave it. Or Medicare, which pays anesthesiologists less than it costs to provide care.
Ask me how I know.
I will give him the benefit of the doubt that his comment about anesthesiology was off the cuff and not well thought out.
The FTC is bringing a case alleging that in many states, they do have monopoly pricing power. https://www.fiercehealthcare.com/regulatory/ftc-secures-11th-hour-settlement-pe-firm-welsh-carson-over-alleged-roll-scheme
Thanks, Matt. The Private Equity raccoons who ‘roll up’ anesthesia practices may do that as part of their business strategy, but I’m fairly certain there’s not an anesthesiologist among them. Perhaps I’m being too sensitive here, but I think a better way to phrase it would have been “large national private equity-owned anesthesia staffing companies” Then again, ‘anesthesiologists’ is just shorter I guess (though less accurate). Love your work and podcasts.